Wangdi Sherab, Dechen Pema, Dorji Kinley, Choden Jambay, Drakpa Loday, Tshering Pema, Tshering Kinley, Tshering Tashi, Dorji Ugyen, Tshering Ugyen
Emergency Department, Eastern Regional Referral Hospital, Mongar, Bhutan
Emergency Department, Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan.
BMJ Open Qual. 2025 Mar 24;14(1):e003132. doi: 10.1136/bmjoq-2024-003132.
Oxygen is the most commonly used drug and is used in the treatment of hypoxaemia. Like any other drug, it should be prescribed appropriately with correct dose via correct device and based on individual needs. Unmonitored and unrestricted use of oxygen can be harmful to patients. The British Thoracic Society has set guidelines about the indication of oxygen use, target goals and how we can titrate oxygen according to the needs of the patients. A quality improvement project was undertaken with the aim of improving the oxygen prescription among the health personnel and improving the appropriate delivery of oxygen to the patients in an emergency department at a national referral hospital in Bhutan for a period of 12 weeks. Our team implemented five Plan-Do-Study-Act cycles based on the data analysis of each cycle, following discussions and after reviewing previous quality improvement projects. The intervention of team education and sensitisation and frequent reminders via posters, emails and group messages were effective in improving the compliance and prescription rates. The doctors' prescription improved from 20% to 82% and nurses' oxygen record from 22% to 83%, and patients receiving oxygen consistent with valid prescription improved from 34% to 86%.
氧气是最常用的药物，用于治疗低氧血症。与其他任何药物一样，应根据个体需求，通过正确的设备以正确的剂量合理开具处方。无监测和无限制地使用氧气可能对患者有害。英国胸科学会已制定了关于氧气使用指征、目标以及如何根据患者需求滴定氧气的指南。在不丹一家国家转诊医院的急诊科开展了一项质量改进项目，旨在提高医护人员的氧气处方水平，并在12周内改善向患者适当提供氧气的情况。我们的团队在对每个周期进行数据分析后，经过讨论并参考之前的质量改进项目，实施了五个计划-执行-研究-行动周期。团队教育和宣传干预以及通过海报、电子邮件和群组消息进行的频繁提醒，有效地提高了依从性和处方率。医生的处方率从20%提高到了82%，护士的氧气记录率从22%提高到了83%，接受符合有效处方氧气治疗的患者从34%提高到了86%。
